HIV and Covid-19 Infection and Its Effect on Neonatal Outcomes in the Greater Accra Region of Ghana

Abstract

Background: Amid the COVID-19 pandemic, people living with HIV experience more severe outcomes and have higher comorbidities from COVID-19 than non-HIV individuals. Pregnant women are a vulnerable group in this population because of their reduced immunity. Objective: This study seeks to ascertain the effect of HIV and COVID-19 infection in neonatal outcomes in the Greater Accra Region of Ghana using Apgar score Methodology: This study is an analysis of secondary data of 37 pregnant women from a longitudinal cohort study of 1,444 pregnant women. Frequencies and percentages were used to describe the categories. Multivariate regression analysis was employed to determine the effect of COVID-19 exposure on Apgar scores. Data was analysed using STATA version 16 software. Results: The prevalence of HIV among pregnant women in the Greater Accra Metropolis was 2.57%. Approximately 49% of babies were born to mothers exposed toCovid-19 and 51% were born to mothers who were not exposed to Covid-19. The median gestational age at delivery was 40 weeks. Pre-term births were recorded among unexposed mothers only and were approximately 8.1%. A total of 91.9% term births were recorded with a higher proportion from exposed mothers (48.6%) than unexposed mothers (43.2%). Approximately 43.2% of babies born from covid-19 exposed mothers were of normal birth weight. An estimated 5.4% of babies born to covid exposed mothers were underweight. The mean Apgar scores recorded at 1 minute and 5 minutes are 7.2 and 8.3 respectively (p-value, 0.044). All babies admitted to NICU were born to covid exposed mothers. The average Apgar1minute scores was 3.16 (AOR = 3.16, 95%CI (0.12-2.18)) higher among children born through emergency caesarean section compared to those born via Spontaneous vaginal delivery. Apgar 5minute scores was 2.27 (AOR = 2.27, 95%CI (0.02-1.64)) higher among children born through emergency caesarean section compared to those born via Spontaneous vaginal delivery. Conclusion: These findings suggest that COVID-19 did not adversely affect Apgar scores of babies born to mothers with HIV. The management of HIV women in labour with indication for c-section contributes to a higher neonatal Apgar score.